Healthcare Provider Details

I. General information

NPI: 1174410328
Provider Name (Legal Business Name): MAYA MEI PINON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6801 JEFFERSON ST NE STE 301
ALBUQUERQUE NM
87109-7390
US

IV. Provider business mailing address

8323 TIERRA SERENA PL NE
ALBUQUERQUE NM
87122-2841
US

V. Phone/Fax

Practice location:
  • Phone: 505-705-1701
  • Fax: 505-212-1253
Mailing address:
  • Phone: 505-321-1199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: